Shopko Stores Operating Co LLC
NPI #1821042003 in Clintonville, Wisconsin
Provider Information
- NPI Number
- 1821042003
- Entity Type
- Organization
- Organization Name
- Shopko Stores Operating Co LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- May 20, 2006
- Last Updated
- Sep 24, 2012
Practice Location
- Address
- 291 S MAIN ST
- City
- Clintonville
- State
- Wisconsin
- ZIP Code
- 54929-1604
- Phone
- (715) 823-2350
Authorized Official
- Name
- MR. MICHAEL BETTIGA, RPH
- Title
- EXECUTIVE VICE PRESIDENT & COO
- Phone
- (920) 429-4297
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
| Pharmacy |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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